Similarities Between Difficult Clients And Their Therapists

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

The more we are irritated and indignant about certain clients who annoy us especially, the more we resemble them, although we are not inclined to admit it. By comparing the most common characteristics of clinicians and their most difficult patients, Ford came to a startling conclusion. Most doctors agree that they are most concerned about patients with chronic somatisation disorders, for whom going into illness is a way of being. This includes patients with chronic pain syndrome who have become accustomed to their role, or those who constantly complain of symptoms against which medicine is powerless. In particular, we are talking about hypochondriacal and hysterical tendencies, simulation, conversion disorders.

All these patients share common characteristics, which is not surprising. For example, patients with somatisation disorders often come from orphanages where their vital needs are not fully met. Often in childhood, such patients witnessed a serious illness or death of loved ones. They are characterized by severe depression, drug abuse, poverty of emotions. The most surprising thing happened when Ford compared all these qualities with the most common characteristics of doctors: it turned out that between doctors and their patients there is much in common.

There are other parallels between difficult patients and their doctors. So if the patient suffers from hypochondria, the doctor, on the contrary, tends to downplay the importance of illness and death. The patient demonstrates a clear tendency to addiction - the doctor becomes willing to fight against such aspirations of the client. The patient needs patronage, and the doctor, meanwhile, indulges in illusions about his own unlimited possibilities. After analyzing his findings, Ford comes to the following conclusion: "Due to psychological affinity, patients with somatisation disorders have the ability to induce intrapsychic conflicts in their doctors."

It makes sense to understand how Ford's observations can be used in therapeutic interactions: are there really similarities between us, our personality problems, and those clients who generate our most negative emotions? What is it?

It is not uncommon for psychotherapists to come to work like their clients, somewhat agitated by domestic conflicts. What we have in common are the ability to influence other people, a high sensitivity to the feelings of others, a tendency to react violently to manifestations of dependence, as well as a desire for power and domination in interpersonal relationships. All of this suggests that our most problematic clients carry our negative traits; however, our own emotional responses to clients can provide a clue to finding ways to work with them.

Since difficult clients are most often characterized by their influence on the therapist - the ability to cause his anger, irritation, anxiety or concern, it is important to know the range of your response. What types of clients, with what diagnosis, and behavior constantly confuse you? At any rate, even if you disagree that your own preconceptions make the client difficult, you probably will not object to the fact that the client and the therapist are equally responsible for the problems that arise in the interaction.

When the psychotherapeutic process encounters an obstacle, the first step is to analyze your behavior.

• What am I doing that creates or exacerbates problems in the therapy alliance? Why do I perceive this client differently in person and on the phone? The impression is that I want to show him who is in charge here when he clearly invades my territory.

• What unresolved personal issues were raised during the conflict? I am probably trying to do too much for this lady and take full responsibility for the development of events. No, I simply do not have a specific plan of action. I feel frustrated when I don’t know where we are and whether she likes our work together. This woman keeps me in the dark, so I have to show sarcasm, sarcasm in order to provoke at least some kind of reaction. And what I get in response, I do not like.

• Whom does this client remind me of? Uncle Matt. Definitely him. They both use the same methods to tame a person. I remember how many times he spoke to my teeth …

• How do I act out my impatience and frustration with the client's success? She just asked me to reschedule our next meeting, because she would not be able to come on time. Why did I react so violently to this? Usually I am much more willing to make this kind of concession.

• What do I expect from this client? This guy is really suffering because his father is in the hospital. I tell him about my father, about that. that I understand his feelings, and he scolds me, as if I were a servant who meddles in his own business. Perhaps my frankness was useless.

• Do I have needs of my own that are not met in this relationship? I wait, no, I demand that people show some gratitude towards me for what I am doing for them. Although my professional services are paid, I do this business mainly because I want to help people. To be honest, it even gives me a sense of power. When a client doesn't appreciate my efforts, I feel cheated.

You can think of other questions on your own to understand why a particular client is causing you anxiety or why you are not working as efficiently as usual: What information do you lack to better understand what is happening? What were your actions wrong? Why were you clearly trying to get the client to do what you saw fit? Do you have a bias towards this client? Finally, the most important question to ask yourself is: What is stopping you from showing more concern and empathy for this person?

By honestly answering all of the above questions, you will most likely be able to understand why the case was so difficult, and you will also see your own role in escalating problems, rather than blaming the client for resistance and unwillingness to cooperate. Difficult clients are usually for one of two reasons:

1) they are not sure that the therapist understands and accepts them, or

2) they are afraid to let the therapist get too close.

In any case, by noting his own feelings of anger and frustration, and by taking into account his unresolved problems, the therapist can understand the reasons and work through the client's resistance.

Ford, C. V. The Somatizing Disorders 1981

Kottler, J. A. The compleat therapist. Compassionate therapy: Working with difficult clients. 1991